[0001] The invention relates to a device for conveying blood flow during liver surgery.
[0002] It is known that surgical operations involving the liver of a patient, both those
which provide its removal and those during which it is necessary to temporarily bypass
the hepatic vascular system, have numerous problems.
[0003] The technique which entails the clamping of the vena portae and the superior vena
cava during surgery causes the unfavorable condition of marked renal and intestinal
hypertension with possible severe clinical consequences.
[0004] In order to obviate this situation, attempts have been made to establish an extra-corporeal
circulation, but with such methods as to cause hardly negligible technical and logistic
problems.
[0005] Another unfavorable circumstance which arises in the known technique resides in the
fact that the extensive bleeding produced forces very fast surgical actions on the
part of the surgeon and the adoption of auto-transfusion, with all the problems which
arise therefrom.
[0006] The aim of the present invention is to provide a device for conveying blood flow
during liver surgery which allows to eliminate all clinical problems for the patient,
which allows the surgeon to operate in the most favorable conditions and has maximum
simplicity.
[0007] The proposed aim is achieved by a device for conveying blood flow during liver surgery,
according to the invention, characterized in that it comprises a first tubular element
with a sealingly slidable internal obturator adapted to be inserted in the body of
the patient passing through the right external jugular vein, the right cardiac atrium
and the superior vena cava to be connected to the inferior vena cava, said first tubular
element having, in such a position as to be external to the patient's body after insertion
has occurred, a connection to a second tubular element adapted to be connected to
the vena portae and being furthermore provided with through holes in the wall portion
intended to be comprised inside the cardiac atrium.
[0008] Further characteristics and advantages will become apparent from the description
of a preferred but not exclusive embodiment of the invention, illustrated only by
way of non-limitative example in the accompanying drawings, wherein:
figure 1 is a partially sectional view of the invention;
figure 2 is a view of the invention during an application.
[0009] With particular reference to the above figures, the reference numeral 1 indicates
the first tubular element, made of any polymeric material with a good degree of biocompatibility,
such as for example polyurethane, internally provided with the sealingly slidable
obturator 2, which is illustrated in figure 1 in the position it assumes during the
insertion of the element 1 in the patient's body, whereas in figure 2 it is illustrated
in the position it assumes during surgery, as will be better explained hereinafter.
[0010] Said tubular element 1 is adapted to be inserted in the patient's body passing through
the right external jugular vein 3, the right cardiac atrium 4 and the superior vena
cava 5 to be connected to the inferior vena cava 6 during surgery requiring the removal
of the liver, which is indeed interposed between said veins 5 and 6, or the temporary
bypassing of the liver vascular system.
[0011] The element 1 is provided, in the wall portion intended to be comprised inside the
cardiac atrium 4, with through holes such as 7 which return blood to the heart.
[0012] The connection 8 to the second tubular element 9 is provided on said element 1 in
such a position as to be external to the body of the patient when the first tubular
element 1 is completely inserted; said tubular element 9 is adapted to be connected
to the vena portae 10 after defining a path outside the patient's body.
[0013] The constructive details to be observed are constituted by the tapered shape, such
as 1a, of the ends of the tubular elements, and by the fact that the continuity of
the internal surfaces of the walls of said tubular elements is maintained inside the
connection 8 so as to avoid any trauma to the blood which affects them.
[0014] The operation of the invention is evident.
[0015] The tubular element 1 is inserted in the right jugular vein 3 through an incision
in the patient's neck, with the obturator 2 protruding from the ends 1a, and is then
inserted in the right cardiac atrium 4 and in the superior vena cava 5 to be connected
to the lower vena cava 6.
[0016] The connection 8 has remained external to the patient's body, and the second tubular
element 9, after a certain external path, is also inserted in the patient's body and
is connected to the vena portae 10.
[0017] When the entire apparatus is connected by ligature of the tubular elements to the
veins, the obturator 2 is retracted until it reaches the position of figure 2, and
in this manner the return of venous blood from the lower caval system and from the
portal system is re-established even when the liver is removed or the vascular system
thereof is bypassed.
[0018] From what has been described the advantageous characteristics of the invention are
evident; the invention allows, with a very simple device, to maintain high blood flows
from the vena portae and from the inferior vena cava to the right cardiac atrium while
the liver is bypassed from circulation, so as to clinically protect the patient, and
furthermore allows the surgeon to operate with maximum comfort.
[0019] The described invention is susceptible to numerous modifications and variations,
all of which are within the scope of the inventive concept; all the details may furthermore
be replaced with technically equivalent elements.
[0020] In the practical embodiment of the invention, the materials employed, as well as
the shapes and dimensions, may be any according to the requirements.
[0021] Where technical features mentioned in any claim are followed by reference signs,
those reference signs have been included for the sole purpose of increasing the intelligibility
of the claims and accordingly such reference signs do not have any limiting effect
on the scope of each element identified by way of example by such reference signs.
1. Device for conveying blood flow during liver surgery, characterized in that it
comprises a first tubular element (1) with a sealingly slidable internal obturator
(2) adapted to be inserted in the body of a patient passing through the right external
jugular vein (3), the right cardiac atrium (4) and the superior vena cava (5) to be
connected to the inferior vena cava (6), said first tubular element (1) having, in
such a position as to be external to the patient's body after insertion, a connection
(8) to a second tubular element (9) adapted to be connected to the vena portae (10),
and being furthermore provided with through holes (7) in the portion of wall intended
to be comprised inside the cardiac atrium.
2. Device according to claim 1, characterized in that said the ends (1a) of the two
tubular elements (1,9) intended to be inserted in the patient's body are tapered to
facilitate the insertion operation.
3. Device according to one or more of the preceding claims, characterized in that
the continuity of the inner surfaces of the walls of the two tubular elements (1,9)
is maintained inside the connection (8) between said tubular elements, so as to avoid
any trauma to the blood which affects them.